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APPLICATI& FOR CONSTRUC*DN PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET• EVERETT, WA 98201 A 257-8810 <br />DEMOLITION COMBINATION -.BUILDING MECHANICAL l PLUMBING SIGN <br />ADDRESS <br />v. T <br />TLIIAxT <br />CITY rw r..mu <br />Tn <br />� seouxev�s <br />PLUGBiM LDx1F4I0"T GABEDDTE;S CITY Ir M1lpllC BTIIE LILLN$U <br />coaRAcT w'nE °T �PZ- yy) <br />HEATING SYSTEM: M GAS ❑ ELECTRIC ❑ <br />RIBL KMM1 AAw ssovi•(E Eroot!!4&ayawD <br />f �l <br />LCNTAct mnsom1 ANTI A1}E No <br />SEs' �c-) T <br />I HEREBY CERTIFY THAT I HAVE REAL, AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORI LAW 1627 RCWAND 296MWAC. <br />1 <br />„ <br />sC'viST��L DATE <br />_ <br />E nar vUSE oT Bvw <br />LEG4 DESCxwlrovaPxrn[Rry 111 n BEww ox A17ACG TWO COPIcsr <br />Lot AlF 2/. KDCA <br />F <br />PARCEL TAI I D xvGew <br />c;;ZZL••Exaf <br />L,, <br />— <br />PLUMBING <br />,It, B.5Tks5 L 1EEx5Ew <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE ON ITEM <br />FEE <br />NO, <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC — A'HNDLG UNITS <br />BATHTUB <br />I <br />FORCED AIR SYSTEMS <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />! <br />SHOWER <br />) <br />UNIT HEATERS <br />KITCHEN SINK 6 DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />I <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />i <br />DRINKING FOUNTAIN <br />i <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />I <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />OAS RANGE <br />SINK (SERVICE — BAR, ETC J <br />GAS PIPING <br />1 <br />i <br />EXHAUSTFAN <br />i <br />I <br />SUBTOTAL S <br />I <br />SUBTOTAL S <br />PERMIT S <br />PERMIT 5 <br />TOTALFEE 5 <br />i <br />TOTALFEE $ <br />J_ <br />FOR OFFICE USE ONLY: <br />FRONT SETB•LM <br />20 <br />REAR SETBACIK <br />Zo <br />SIDE SETBALN <br />MCI, NUMBER <br />2 L7` <br />E[E <br />4(0• <br />xECEWT AID <br />USE 7 <br />Lm ARE <br />w.T SITE <br />AGES GYa <br />FEES <br />VALUATION <br />FEE <br />evAoxG <br />1L,� <br />rrtwRTLIurtA 1 <br />AD"OWL4 <br />MIS <br />s¢EOE BLW TI L <br />RUGB N] <br />OLLUP•NCY NJ CA;RNfE <br />OL6UPAxl 1Osp B•5[MLNT <br />NECtIANSAl <br />GRWP <br />nj LL ❑YEB <br />V <br />fWE SPRI IM((LLR REOD <br />LS <br />RF•SON ^ <br />L) 1) ( <br />AccaID L"CNECN <br />01NER <br />EPE• RG RCOD <br />[ <br />REASPI <br />O^ o <br />STATE BUMM36URLNARGE <br />rcPEa covslJ <br />FUNS.IovEo er <br />M <br />CITY OF EVERETT <br />LOCAL ES <br />M&C WORAS <br />`1 <br />_�IT <br />D•TE .00 <br />TAX CODE SL3 05 <br />TOTAL <br />uy <br />